Findings from University of California advance knowledge in managed care
2008 JAN 14 -- In this recently published study, investigators in the United States conducted a study "To determine whether health plan members who saw physicians participating in a quality-based incentive program in a preferred provider organization (PPO) setting received recommended care over time compared with patients who saw physicians who did not participate in the incentive program, as per 11 evidence-based quality indicators. Administrative claims data for PPO members of a large nonprofit health plan in Hawaii collected over a 6-year period after the program was first implemented." "An observational study allowing for multiple member records within and across years. Levels of recommended care received by members who visited physicians who did or did not participate in a quality incentive program were compared, after controlling for other member characteristics and the member's total number of annual office visits. Data Collection. Data for all PPO enrollees eligible for at least one of the 11 quality indicators in at least 1 year were collected. We found a consistent, positive association between having seen only program-participating providers and receiving recommended care for all 6 years with odds ratios ranging from 1.06 to 1.27 (95 percent confidence interval: 1.03-1.08, 1.09-1.40)," wrote A.S. Gilmore and colleagues, University of California. The researchers concluded: "Physician reimbursement models built upon evidence-based quality of care metrics may positively affect whether or not a patient receives high quality, recommended care." Gilmore and colleagues published their study in Health Services Research (Patient outcomes and evidence-based medicine in a preferred provider organization setting: A six-year evaluation of a physician pay-for-performance program. Health Services Research, 2007;42(6 Part 1):2140-2159). For additional information, contact A.P. Legorreta, University of California, School Public Health, Dept. of Health Science, Box 951772, Los Angeles, CA 90095, USA. The publisher of the journal Health Services Research can be contacted at: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DQ, Oxon, England. Keywords: United States, Box, Managed Care, University of California. This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2008, Managed Care Weekly Digest via NewsRx.com.
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